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WaPo: Hey, a Republican budget plan actually cuts the deficit - Hotair.com ... GOP, the bill sponsored by Ryan and five other House members would seek to reduce the deficit and spur economic growth by cutting the tax rate on corporations, shifting future Medicare ... such as allowing people to invest money they would pay ... Publ.Date : Fri, 05 Feb 2010 20:37:00 GMT Medicare sucking away dollars - WISH-TV That's even if President Barack Obama's health care overhaul wastes away in congressional limbo. Long in ... will soon start signing up for Medicare. "This does mark a pretty stark jump in the data," said Christopher Truffer of Medicare's Office of ... Publ.Date : Thu, 04 Feb 2010 13:50:00 GMT Enrollment cuts continue to cause headaches to insurers - Worcester Telegram & Gazette Employers will continue to demand lower rates in 2010 while medical costs rise. Medicare Advantage cuts will squeeze some profit margins. And a still-unresolved health care overhaul hangs over the industry. Aetna, UnitedHealth Group, WellPoint and ... Publ.Date : Sun, 07 Feb 2010 10:55:00 GMT Letters: Medicare mess is just getting worse - El Paso Times I am so very upset right now. I called five different doctors' offices to try to find a doctor on the East Side of town. Not one of them is accepting new Medicare patients, even with co-insurance. Now, why is that? It's because Congress does not care ... Publ.Date : Tue, 09 Feb 2010 07:10:00 GMT Dems may add health provisions - including COBRA subsidies and ... - News-Medical.Net Lawmakers may include a number of Medicare "fixes" in the jobs bill, now that the health overhaul bill has stalled, The Hill reports. They would include restoring Medicare provisions that expired Jan. 1 or are set to expire later this year. "Nursing ... Publ.Date : Tue, 09 Feb 2010 04:40:00 GMT RSS feeds Increased Website Traffic

Medical Practice Management Company Influences Major Reimbursement Policies

by June Marshall-kingsley

mpowermed, inc., a medical practice management company in Mahwah, NJ, influenced Aetna and Pennsylvania Centers for Medicare and Medicaid to change their reimbursement policies for certain medical procedures. Both patients and physicians benefit from these reimbursement changes.

The world of medical billing and coding for physician reimbursement is complex and can be daunting. Staying on top of the game with reimbursement policies from such large insurance organizations as Aetna, Medicare, and Medicaid takes knowledge and experience. But sometimes the policies don’t make sense, are not in the physician’s best interest, or have not changed to keep up with current medical practices.

That is where a proactive, dedicated, and experienced practice management company like mpowermed, inc., of Mahwah, New Jersey makes a difference -- by fighting for every cent due when the polices seem unfair, outdated, or simply incorrect for today’s needs. Such was the case with a policy regarding a breast cancer treatment involving a treatment device known as a breast board. Pennsylvania Medicare and Medicaid were denying payment for more than one use of these treatment devices a day. mpowermed appealed with the following words in a letter, “In a given course of treatment, it is most common to see more than a single treatment device in a day. We are confident that all medical documentation would prove medical necessity.”

Because of this letter, the Pennsylvania Center for Medicare and Medicaid Services wrote back to mpowermed saying they researched the treatment device situation and actually visited a large cancer treatment facility, “to view the devices and discuss their use and billing with a radiation oncologist.” Based on these findings, Pennsylvania Medicare and Medicaid will update their policies regarding this treatment device (CPT Code 77334).

Prior to this victory, mpowermed had written to Aetna about rejecting claims for another reimbursable item, Portal Film (CPT Code 77417) usage on the same day as the physician’s weekly management charge (CPT Code 77427). After amassing impressive documentation proof, mpowermed suggested the changes to differentiate between portal film usage in a freestanding clinic versus a hospital setting. Aetna agreed to reimburse the technical use of portal film in freestanding, privately owned radiation oncology clinics.

According to mpowermed, “It takes patience and perseverance to influence policy changes in large insurance organizations. Both Aetna and the Centers for Medicare and Medicaid Services were more than cooperative in affecting the necessary changes. It is for the benefit of the patient and the physician when they do! This is what makes medical practice management, billing, and coding such a rewarding opportunity!”

Company contact:

mpowermed, inc.
June Marshall-Kingsley
Marketing Manager
201-684-1616 Ext. 130
 

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